Two cases of type 1 diabetic women with diabetic ketoacidosis presenting as alkalaemia

Watanabe, Yûko; Noda, Kazushige; Akazawa, Kenichiro; Fukuyama, Jiro

doi:10.1016/j.diabres.2008.11.020

Cited by 5 publications

(2 citation statements)

References 6 publications

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“…This chaotic metabolic interplay results in state of alkalemia. In case series by Svart et al, they observed six patients with diabetic ketoalkalosis; all six patients had commonly associated symptoms of severe nausea and vomiting [3]. There is also evidence that patients having autonomic neuropathy such as gastroparesis due to poorly controlled diabetes, usually present with recurrent vomiting [4].…”

Section: Discussionmentioning

confidence: 99%

Ketoalkalosis: Masked Presentation of Diabetic Ketoacidosis With Literature Review

et al. 2017

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Most dreaded complication in type 1 diabetes mellitus remains diabetic ketoacidosis (DKA): plasma blood glucose > 250 mg/dL, serum bicarbonate < 18 mEq/L, anion gap metabolic acidosis and ketosis. Insulin deficiency with high levels of glucagon and stress hormones causing ketogenesis in liver, elevated lipolysis in peripheral tissues, and increased free fatty acids contribute the formation of ketones leading to metabolic acidosis. And hence DKA is also termed as ketoacidosis. Unusually, patients with diuretic use, alkali ingestion, intractable vomiting, or hypercortisolism may present with alkalemia in DKA. Contraction (Metabolic) Alkalosis masquerades metabolic acidosis with anion gap and low to normal bicarbonate that uncovers on provision of intravenous fluids. We present a case of a 25-year-old female with DKA presenting with intractable vomiting, alkalotic pH and high anion gap.

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Section: Discussionmentioning

confidence: 99%

Ketoalkalosis: Masked Presentation of Diabetic Ketoacidosis With Literature Review

et al. 2017

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“…The factors related with alkalemia in DKA were; recurrent vomiting which causes hydrogen and chloride ion loss (autonomic neuropathy such as delayed gastric emptying might have been related to recurrent vomiting), alkali ingestion and contraction alkalosis due to dehydration and/or diuretic use [100]. Treatment of diabetic ketoalkalosis does not differ from that of pure DKA.…”

Section: >12mentioning

confidence: 99%

Diabetic Ketoacidosis

Cesur¹,

Sayi²

2013

Type 1 Diabetes

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Diabetic ketoacidosis masquerading behind alkalemia an undiagnosed or missed variant of diabetic ketoacidosis

Rajasegaran

Tamilarasan

Kalaimani

2022

Journal of Pediatric Endocrinology and Metabolism

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Objectives Diabetic ketoacidosis is a common emergency in type 1 diabetes mellitus patients. But rarely, they may present with alkalemia instead of acidosis. Diabetic ketoalkalosis which has been reported in adults can also be present in children with type 1 DM. The usual factors causing alkalemia were not found in our patients. This entity may manifest in both newly diagnosed and treated patients. Case presentation The first patient, an 8 year male presented with features of DKA, was diagnosed for the first time as type 1 DM, but was found to have alkalemia. The second patient, a 7 year female was a known case of Type 1 DM on insulin, who presented with dehydration and alkalemia. Both were treated with hydration and insulin and made complete recovery. Conclusions A normal or alkalotic pH does not essentially eliminate DKA and needs to be evaluated further to identify the underlying acid–base disturbance.

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Two cases of type 1 diabetic women with diabetic ketoacidosis presenting as alkalaemia

Cited by 5 publications

References 6 publications

Ketoalkalosis: Masked Presentation of Diabetic Ketoacidosis With Literature Review

Ketoalkalosis: Masked Presentation of Diabetic Ketoacidosis With Literature Review

Diabetic Ketoacidosis

Diabetic ketoacidosis masquerading behind alkalemia an undiagnosed or missed variant of diabetic ketoacidosis

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